AB1163 ATTITUDES AND HESITANCY IN PATIENTS WITH INFLAMMATORY RHEUMATIC DISEASES TOWARDS SARS-CoV-2 VACCINATION: A SINGLE-CENTER STUDY FROM BULGARIA
Authors: T. Georgiev, R. Moraliyska, S. Bogdanova-Petrova, G. Gerganov, P. Kabakchieva, S. Dimitrov, S. Hristova, T. Shivacheva
Journal: Annals of the Rheumatic Diseases (2022)

Background Bulgaria is among the countries with the lowest vaccination rate of adult population in Europe. The presence of autoimmune rheumatic disease could further contribute to vaccine hesitancy and skepticism and influence patients’ attitudes towards vaccination [1, 2]. However, little is still known about the willingness and particular causes of hesitancy in patients with inflammatory joint diseases in the skeptical part of adult population across Europe. Objectives Our goal was to assess the rate of SARS-CoV-2 vaccination among patients with immune-mediated rheumatic joint diseases receiving biological and targeted synthetic disease-modifying antirheumatic drugs (DMARDs) and to determine the modifiable predictors of vaccination hesitancy. Methods Patients with rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis undergoing biological or targeted synthetic DMARDs therapy were consecutively selected and included in this single-center cross-sectional study. Excluding criteria in patients were psychiatric or neurological disease preventing understanding or responding to the questions, being illiterate, or not willing to participate in the study. Various demographic, anthropometric, and clinical data were collected. Disease activity was determined using DAS28-CRP for rheumatoid arthritis and peripheral psoriatic arthritis and ASDAS for ankylosing spondylitis and psoriatic spondylitis. All patients were given a questionnaire assessing their vaccination status, hesitancy, and attitude towards vaccination. Binary logistic regression analysis was used to analyze the relationship between self-reported modifiable parameters and vaccination status for SARS-CoV-2. Results Two hundred and one participants were eligible for participating in the study with mean age and BMI of 54.6 years and 28.2, respectively. Of these, 40.3% were women; 30.3% had rheumatoid arthritis, 17.9% - psoriatic arthritis, and 51.7% - ankylosing spondylitis. 29.4 % of all participants had already survived a COVID-19 infection with a mean time of 8.4 months since the COVID-19 onset. Only slightly above 1/3 (35.8%) of the study group was fully vaccinated and the majority of them were vaccinated with BNT162b2 (68.1%). Among the modifiable factors, we identified preceding discussion with a rheumatologist, hesitancy due to autoimmune disease presence and (un)awareness of vaccine safety and efficacy as significant predictors of vaccination status Conclusion Our data suggest that there are still possibilities to influence rheumatic patients on their decision to vaccinate against SARS-CoV-2 in Bulgaria. Raising the awareness of the safety and efficacy of the SARS-CoV-2 vaccines and spending more time on the education of patients with rheumatic diseases may positively affect their attitude towards vaccination. References [1]Gaur P, Agrawat H, Shukla A. COVID-19 vaccine hesitancy in patients with systemic autoimmune rheumatic disease: an interview-based survey. Rheumatol Int. 2021;41(9):1601-1605 [2]Georgiev T, Angelov AK. Complexities of diagnosis and management of COVID-19 in autoimmune diseases: Potential benefits and detriments of immunosuppression. World J Clin Cases. 2020 Sep 6;8(17):3669-3678 Disclosure of Interests None declared